Individual provider Active NPI

Gene Theriault

  • Peer Specialist
  • Leominster, MA
National Provider Identifier
1245142231
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
100 Erdman Way
Leominster, MA 01453-1804
Phone
(978) 340-1772
NPI assigned
Sep 22, 2026
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MA Primary

Addresses

Primary practice location

100 Erdman Way
Leominster, MA 01453-1804

Mailing address

100 Erdman Way
Leominster, MA 01453-1804
Phone (978) 340-1772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1245142231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531804",
            "telephone_number": "978-340-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531804",
            "telephone_number": "978-340-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "GENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.